When children are sick they still need insulin at their usual times. In fact, they may need extra injections of short-acting
or fast-acting insulin as often as every 4 hours, if they show high blood sugar or urine ketones. To decide how much insulin
to give, check the blood sugar and urine ketones every 4 hours. Consult this chart each time. The following illness scenarios
offer courses of action depending on results of the blood glucose and urinary ketone tests.
Blood glucose
|
Urinary ketones
|
Action
|
|
6.0-13.0 mmol/L
(110-230 mg/dL)
|
negative or small
|
Give the usual insulin at the usual time, but do not give extra. Test again in 4 hours.
|
|
> 13.0 mmol/L
(over 230 mg/dL)
|
moderate or large
|
Give the usual insulin at the usual time. In addition, give more of the short-acting or fast-acting insulin (10% to 20% of
the total daily dose) now. Test again in 4 hours.
|
|
> 17.0 mmol/L
(over 300 mg/dL)
|
negative or small
|
Give the usual insulin at the usual time. In addition, give more of the short-acting or fast-acting insulin (10% to 20% of
the total daily dose) now. Test again in 4 hours.
|
|
< 6.0 mmol/L
(under 110 mg/dL)
|
negative or positive
|
If it is time to give insulin, reduce the dose by 10% to 20%. Encourage your child to have sugar-containing fluids. Speak
to your doctor if further reductions are required, or if vomiting occurs.
|
To figure out how much more fast-acting insulin to give, add up the total daily insulin dose.
How to figure out changes to the dose
Here is an example to help you figure out how much fast-acting insulin to give.
Consider a child taking:
-
20 units of intermediate-acting and 4 units of fast-acting insulin before breakfast
-
4 units of fast-acting insulin before supper
-
7 units of intermediate-acting insulin before bed
This child has a total of 35 units of insulin a day. Ten percent of 35 units is 3.5 units. Twenty percent of 35 units is 7
units.
For this child, you would give 4 to 7 units. Do not give more than 10 extra units at any one time. Small children tend to
be sensitive so for them you should start with dosages at the lower end of the range.
